Hypothyroidism

Question 1

Deficiency of the thyroid hormones

Answer 1

Hypothyroidism

Question 2

Hypothyroidism is common in _______ between ______ yrs old; incidence rises after age ___

Answer 2

Women; 40-60; 50

Question 3

Basic Concepts of Hypothyroidism

Answer 3

a. Decrease metabolic rate: ⬇️T3
b. Decrease body heat production: ⬇️T4
c. Hypercalcemia: ⬇️Thyrocalcitonin

Question 4

Causes of hypothyroidism (ARAT)

Answer 4

a. Autoimmune disorders
b. Radioactive iodine
c. Antithyroid drugs
d. Thyroidectomy

Question 5

Hypothyroidism in adults; nonpitting edema in the connective tissue throughout the body

Answer 5

Myxedema

Question 6

Signs of myxedema (PEH)

Answer 6

a. Puffy face
b. Enlarged toes
c. Hoarse voice

Question 7

Hypothyroidism in children

Answer 7

Cretinism

Question 8

Cretinism is the result of water retention in mucoprotein deposits in the interstitial spaces known as ____________________

Answer 8

Hydrophilic proteoglycans

Question 9

Caused by congenital defects in the gland, loss of thyroids tissue following surgery or radiation, antithyroid medications, thyroiditis

Answer 9

Primary hypothyroidism

Question 10

Another cause of primary hypothyroidism

Answer 10

Amiodarone (Codarone)

Question 11

Results from pituitary TSH deficiency

Answer 11

Secondary Hypothyroidism

Question 12

Initial sign of hypothyroidism

Answer 12

Fatigue

Question 13

Manifestations of hypothyroidism

Answer 13

a. Goiter
b. Anorexia
c. Edema
d. Weight gain
e. Constipation
f. Dry skin
g. Pruritus
h. Dyspnea
i. Hoarseness
j. Muscle stiffness
k. Decreased sense of taste and smell
l. Menstrual disorders
m. Anemias
n. Cardiac enlargement

Question 14

Abnormalities in lipid metabolism with elevated serum cholesterol and triglyceride

Answer 14

Atherosclerosis

Question 15

Due to decreased renal blood flow and glomerular filtration rate that reduces the kidney’s ability to excrete water

Answer 15

Hyponatremia

Question 16

Thyroid Preparations

Answer 16

a. Levothyrocine Sodium (T4), Levoxyl, Levothyroid, Synthroid
b. Liothyrobine Sodium (T3), Cytomel
c. Thyrolar, Thycar (Thyroid)

Question 17

Treatment of choice of hypothyroidism

Answer 17

Levothyroxine

Question 18

Effects of Levothyroxine

Answer 18

Increases CO, body temp, and oxygen consumption

Question 19

When is levothyroxine given?

Answer 19

1 hour before meals or 2 hours after meals

Question 20

What should you take before administering levothyroxine?

Answer 20

Apical pulse (<60 rebound tachycardia)

Question 21

Effect of anticoagulant drugs: WOF?

Answer 21

Bleeding

Question 22

Effect of digitalis:

Answer 22

Toxicity

Question 23

Monitor for symptoms of?

Answer 23

Coronary insufficiency
a. Chest pain
b. Dyspnea
c. Tachycardia

Question 24

Life threatening complication of longstanding untreated hypothyroidism usually triggered by an acute illness or trauma

Answer 24

Myxedema Coma

Question 25

Occurrence and incidence of myxedema coma

Answer 25

a. Rare
b. Winter months
c. Failure to take thyroid replacement medications

Question 26

Characteristics (severe metabolic disorders)

Answer 26

a. Hypoglycemia
b. Hypotension
c. Hyponatremia
d. Hypothermia
e. Lactic Acidosis
f. Bradycardia
g. Respiratory Failure
h. Coma
i. ALL VITAL SIGNS ARE PROFOUNDLY DEPRESSED

Question 27

Myxedema coma management

Answer 27

a. Maintain patent airway
b. Administer IV fluids and Synthroid/IV as prescribed
c. Administer glucose/IV as ordered
d. Monitor client’s temperature. Keep client warm.
e. Monitor BP. Manage hypotension.
f. Monitor LOC
g. Monitor electrolyte and glucose levels